Health Records

The personal health record (PHR) is an electronic, universally available, lifelong resource of health information needed by individuals to make health decisions.

Read about the project below

What is PHR?

The personal health record (PHR) is an electronic, universally available, lifelong resource of health information needed by patients to make health decisions. Patients own and manage the data in the PHR, which comes from healthcare providers and the patient. The PHR is maintained in a secure and private environment, with the patient determining rights of access.

PHR at Practo

Health record as a feature was launched on the mobile application in 2015. Since then, we have shipped six significant updates of the records module on to the app and have built a similar experience on the web platform of Practo as well. PHR has proven to be one of the most loved features of the Practo app.

Team & Role

I was one of the initial members of the PHR team here at Practo. We built the record sharing and storing tool when Hetang, a fantastic designer from Genii, joined us to increase the usability of the feature and to take it to the next step.

Identifying the user

After months of research and building solutions for PHR, here at Practo, we understood that our primary user group is chronic patients. We did a lot of market research, worked through our analytics and data, spoke to doctors and other providers before coming up with this conclusion. Chronic patients have numerous records from several problem areas. They find it troublesome to keep track of doctor visits, prescriptions, and medicines. Moreover, there is no straightforward way for them to prompt them to do their daily chores.

My mother is a primary user. She has been fighting a chronic disease for the past 15 years, and I have seen the troubles that she has had to face. Maybe this was the most significant push for me to join Practo and help create the world's most comprehensive PHR product.

Identified persona for PHR

Understanding the problem

I spoke to 40 patients with various chronic diseases such as Asthma, Arthritis, Diabetes, etc. Surprisingly, most of them had very comparable pain points. I inquired about their everyday routine and the way they maintained and stored their health records. This assisted me to infer the immense amounts of obstacles and hardships these patients face every single day due to the age-old health system.

Detailed user journey for a diabetic chronic patient

The rest of the Practo app worked for the initial three stages of the journey. PHR was focused entirely on stage 4 of the chronic patient's journey. To determine and prioritize the most critical user flows, we used the Red Routes analogy defined by Dr. Travis. He used to compare advancements in speed and simplicity online with the red routes of buses in London. The darkest marked routes, in the Red Route analysis chart, are the behaviors that are most critical to our users.

Red route analysis was done on the user journey for a diabetic patient

After this activity, we determined which all user behaviors and actions are of prime significance to them and hence helped us in prioritization. Going deeper into these actions, we created a list of major problems which our product had to fix.

Sharing of records happens physically in the form of enormous bundles of paper

Storing is done in physical folders which is easy to misplace and not easy to carry around

Records are difficult to understand for patients

Medical folders do not give a snapshot of the patient’s health. Doctors need to spend minutes before understanding the patient’s health journey

Tough to search or retrieve something from these folders

Patients need to rely on family members to remind them to buy and take medicines

Medical folders are easily damaged and hence not secure

Lack of a trusted source of personal, contextual and trustable source of health information

Records are stored chronologically in folders, while doctors suggest them to be stored via problems

No way to see trends and analyze progress on vital signs and billing is a chaotic and time-consuming process

Have to visit doctors for every small concern

Solution

PHR product at Practo

All medical records of the patient at one place by storing them in the cloud.

Records are with the patient on their mobile device wherever they go.

Medical records are safe and secure. Practo ensures that only the patient can access their healthcare information.

Access to these medical data by other offerings at Practo. The patient can now order medicines, set reminders or share records with doctors with just a simple tap.

Easy record creation and sharing

Practo has created a powerful practice management software called Ray which currently serves 50,000+ doctors in India and abroad. Doctors can leverage smart templates to provide advisory faster than writing on the paper itself. Doctors save money on paper and time needed for legal documentation. With this software, they can easily create a medical history of the patient.

Record creation and sharing in Practo Ray

Doctors can they automatically share records from Ray to the patient's health app. This entire exchange is created behind an incredible layer of security and end to end encryption. Doctors now save time, money, ink and paper.

Medical folders - redesigned

Temporal Structure

After iterating and designing many solutions, we (Hetang and me) came up with a model which worked the best for our prime users. We suggested a spatial structuring of records, which meant categorizing the items into sections of upcoming, today and past.

Storing of past health records chronologically though simple is not the most optimum way. Doctors have been recently suggesting patients file records by problem types. A medical history organized solely by chronology does little to help a patient understand where they are and where they need to be on their health journey. Our health-history is non-linear. Diseases come and go, against all logical and professional judgment.

Temporal structure of medical records folder

Personal profile

Patient information is presented in a human way, not a readout from a database. We show the not-so-sensitive medical details here. It gives a summary of the patient's personal data.

Patient's personal profile on the consumer app

Upcoming and today

This is a section which talks about tasks to be done by the user today or in the future. They are shown reverse chronologically (nearest item first). These include upcoming appointments, reminders to take medicines, insights and other vital actions. This section is super personalized and dynamic, presenting only the most essential items.

Upcoming reminders and other action items for the patient

Past

Our research shows that patients, especially chronic, do not remember a medical event by the exact date. The process to recall an incident which happened a couple of years back always leads to them recognizing the cause/diagnosis of the event. For example, I remember having my ribs fractured a year back but not the date when it occurred or the doctor who diagnosed me or any another detail of the appointment. Hence the best identification anchor point for any health event in a timeline is its purpose (speaks a real story for the patient to recollect), which was made the title of the event. All prescriptions, records, and medicines are associated with this event.

Temporal timeline arranged chronologically with records linked to medical events which help in giving context to the problems

Historical information can become overwhelming as complications persist. They become hidden, increasing the cognitive load for doctors to consume that patient information. To solve this, we created a “snapshot” of the patient’s medical history. This helps the patient and doctors to keep track of multiple conditions developed during the years. The holistic health record brings together providers, visits, medications, and lab results, making it easy to keep track of things.

Patient's health history can be seen in a visually. Filter conditions to focus on a holistic view of the problems.

Records - redesigned

We designed every health record to make them more understandable and easy to consume. We reduced the jargon and showed only whats important for the patients. We created actionable recommendations and digestible results. The content was rewritten so that it could be read as a natural sentence.

Simple list-based layout with correct text alignment to convey a rich amount of information in the best way possible

Self-upload records

A smart tool designed to help patients upload photos of the medical records onto the cloud. The feature, unlike a simple camera app, was designed to upload multiple records at the same time while adding a few extra data points. Patients, now can easily add records to their health app and access them from anywhere with ease. This also facilitated easy upload of prescriptions which were shared with a doctor before a consultation or a pharmacy for ordering medicines.

Bulk upload records onto Practo Drive with just two clicks

Reminders

A remarkably simple tool to prompt patients to take their medicines, drink enough water or even take a break at work. Medicine reminder is one of the most patient-loved features on the mobile application. Patient's can also track their adherence to medicine intake which helps doctors and caretakers to provide them with better care.

Reminders on the app reminders patients to take meds and track their adherence

The current version

We launched the first version of PHR on the Practo app in November 2015. Since then the product has seen a lot improvement in functionality and usability. We have shipped more than six versions of the records module of the consumer app. At the same time, we built a seamless solution for doctors and other providers to share records with their patients online.

Though we have not reached the most optimum solution yet, we are proud of taking the first steps towards making accessible health records a reality.

Outcome

PHR is one of the most critical aspects of healthcare. Patient's data helps us understand their needs and problems better. Since the launch of PHR on the Practo app, users have been using it extensively. We see incredibly high engaged users using features like the reminders and bulk-upload of records every single day.

Patients, with whom digital records are shared, book 25% more appointments with the same doctor.